Section - CAP Smart Takes

04. Growth Trajectories in Stimulant-Treated Children Ages 6–12

Published on June 1, 2023 Certification expiration date: June 1, 2026

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

Stimulant exposure in children with ADHD may have a small effect on growth trajectories, particularly in height, but it does not represent a significant clinical concern for most children.
It is best to treat patients with ADHD with stimulant medications for at least 9–12 months at the dose that gets them better before considering tapering the medicine off.
Drug holidays should be used sparingly and only in those few cases with a marked impact on growth trajectories.

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Text version

Hi! David Rosenberg here for the Psychopharmacology Institute. In this CAP—or Child and Adolescent Psychiatry—Smart Take, we will closely examine growth trajectories in children 6–12 treated with stimulant medications. Moreover, this question continues to receive much attention, but uncertainties remain as to whether or not stimulant exposure in children adversely impacts growth trajectories.

Biederman and colleagues do an excellent job examining 323 children 6–12 years of age with ADHD who were exposed to stimulants and received 4 years of follow-up growth assessments. They compared them with 1,615 age and sex-matched children without ADHD.

So, what did they find? Well, small but significant decreases in height trajectories were found in stimulant-exposed children compared with children not exposed to stimulant medications. Weight and body mass index (BMI) trajectories decreased during the first year of stimulant exposure follow-up, but they stabilized and then increased afterward. Height, weight, and BMI trajectory effects were significantly

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05. Efficacy and Tolerability of Antipsychotics for Juvenile Psychotic Disorders

Learning Objectives:

Understand the association between sleep disturbances and increased risk of injury and suicidality in children and adolescents.
Understand the racial and ethnic disparities in psychotropic medication prescribing among pediatric patients and recognize the importance of addressing these disparities in clinical practice.
Evaluate the potential benefits and risks of cariprazine as a treatment option for pediatric patients with schizophrenia and bipolar I disorder.
Understand the impact of stimulant medication on growth trajectories in children with ADHD and the factors that can influence this impact, such as race and total stimulant exposure.
Describe the short- and long-term efficacy and tolerability of antipsychotic medications in youth with psychosis.

Original Release Date: June 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: June 1, 2026

Expert: David Rosenberg, M.D.

Medical Editor: Lorena Rodriguez, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.